Br J Nutr. 2020 May 12;1-20. doi: 10.1017/S0007114520001749
Murat Kara 1, Timur Ekiz 2 timurekiz at gmail.com, Vincenzo Ricci 3, Özgür Kara 4, Ke-Vin Chang, Levent Özçakar 1
Download the PDF from VitaminDWiki
World Health Organization announced the novel coronavirus disease (COVID-19) outbreak to be a global pandemic. The distribution of community outbreaks shows seasonal patterns along certain latitude, temperature, and humidity i.e. similar to the behavior of seasonal viral respiratory tract infections. COVID-19 displays significant spread in northern midlatitude countries with an average temperature of 5-11 °C and low humidity. Vitamin D deficiency has also been described as pandemic, especially in the Europe. Regardless of age, ethnicity, and latitude; recent data showed that 40% of the Europeans are vitamin D deficient (25(OH)D levels <50 nmol/L), and 13% are severely deficient (25(OH)D <30 nmol/L)
A quadratic relationship was found between the prevalences of vitamin D deficiency in most commonly affected countries by COVID-19 and the latitudes.
Note: This equation does not appear to be in the text
Vitamin D deficiency is more common in the subtropical and midlatitude countries than the tropical and high latitude countries.
The most commonly affected countries with severe vitamin D deficiency are from the subtropical (Saudi Arabia; 46%, Qatar; 46%, Iran; 33.4%, Chile; 26.4%) and midlatitude (France; 27.3%, Portugal; 21.2% and Austria; 19.3%) regions.
Severe vitamin D deficiency was found to be nearly 0% in some high latitude countries (e.g. Norway, Finland, Sweden, Denmark and Netherlands).
Accordingly, we would like to call attention to the possible association between severe vitamin D deficiency and mortality pertaining to COVID-19. Given its rare side effects and relatively wide safety, prophylactic vitamin D supplementation and/or food fortification might reasonably serve as a very convenient adjuvant therapy for these two worldwide public health problems alike.
- Coronavirus disease (COVID-2019) situation reports. Geneva: World Health Organization, 2020 (https://www.who.int/emergencies/diseases/novel-coronavirus- 2019/situation-reports/. opens in new tab). Last accessed on 2020 May 4.
- Yuki K, Fujiogi M, Koutsogiannaki S. COVID-19 pathophysiology: A review. Clin Immunol. 2020:108427. doi: 10.1016/j.clim.2020.108427.
- Vaduganathan M, Vardeny O, Michel T, McMurray JJV, Pfeffer MA, Solomon SD. Renin-angiotensin-aldosterone system inhibitors in patients with Covid-19. N Engl J Med. 2020;382:1653-9.
- Zou X, Chen K, Zou J, Han P, Hao J, Han Z. Single-cell RNA-seq data analysis on the receptor ACE2 expression reveals the potential risk of different human organs vulnerable to 2019-nCoV infection. Front Med. 2020 (In Press). doi: 10.1007/s11684- 020-0754-0.
- Eymundsdottir H, Chang M, Geirsdottir OG, et al. Lifestyle and 25-hydroxy-vitamin D among community-dwelling old adults with dementia, mild cognitive impairment, or normal cognitive function. Aging Clin Exp Res. 2020 (In Press) doi:10.1007/s40520-020-01531-1.
- Lopes JB, Fernandes GH, Takayama L, et al. A predictive model of vitamin D insufficiency in older community people: from the Sao Paulo aging & health study (SPAH). Maturitas. 2014; 78: 335-40.
- Urrunaga-Pastor D, Guarnizo-Poma M, Macollunco-Flores P, et al. Association between vitamin D deficiency and insulin resistance markers in euthyroid nondiabetic individuals. Diabetes Metab Syndr. 2019; 13: 258-63.
- Orces CH. Vitamin D status among older adults residing in the littoral and Andes mountains in Ecuador. ScientificWorldJournal 2015; 2015: 545297.
- Clark P, Vivanco-Munoz N, Pina JT, et al. High prevalence of hypovitaminosis D in Mexicans aged 14 years and older and its correlation with parathyroid hormone. Arch Osteoporos. 2015; 10: 225.
- Solis-Urra P, Cristi-Montero C, Romero-Parra J, et al. Passive commuting and higher sedentary time is associated with vitamin D deficiency in adult and older women: Results from Chilean National Health Survey 2016-2017. Nutrients. 2019; 11: 300.
- Formiga F, Ferrer A, Megido MJ, et al. Low serum vitamin D is not associated with an increase in mortality in oldest old subjects: the Octabaix three-year follow-up study. Gerontology. 2014; 60: 10-5.
- Veronese N, Sergi G, De Rui M, et al. Serum 25-hydroxyvitamin D and incidence of diabetes in elderly people: the PRO.V.A. study. J Clin Endocrinol Metab. 2014; 99: 2351-8.
- Aspell N, Laird E, Healy M, et al. The prevalence and determinants of vitamin D status in community-dwelling older adults: Results from the English Longitudinal Study of Ageing (ELSA). Nutrients. 2019; 11: 1253.
- Cougnard-Gregoire A, Merle BM, Korobelnik JF, et al. Vitamin D deficiency in community-dwelling elderly Is not associated with age-related macular degeneration. J Nutr. 2015; 145: 1865-72.
- Vetter VM, Spira D, Banszerus VL, et al. Epigenetic clock and leukocyte telomere length are associated with vitamin D status, but not with functional assessments and frailty in the Berlin Aging Study II. J Gerontol A Biol Sci Med Sci. 2020 (In Press) doi:10.1093/gerona/glaa101
- Karonova T, Andreeva A, Nikitina I, et al. Prevalence of vitamin D deficiency in the North-West region of Russia: A cross-sectional study. J Steroid Biochem Mol Biol. 2016; 164: 230-4.
- Ozturk ZA, Gol M, Turkbeyler JR. Prevalence of vitamin D deficiency in otherwise healthy individuals between the ages of 18 and 90 years in southeast Turkey. Wien Klin Wochenschr. 2017; 129: 854-5.
- Hoge A, Donneau AF, Streel S, et al. Vitamin D deficiency is common among adults in Wallonia (Belgium, 51°30' North): findings from the Nutrition, Environment and Cardio-Vascular Health study. Nutr Res. 2015; 35: 716-25.
- Ten Haaf DSM, Balvers MGJ, Timmers S, et al. Determinants of vitamin D status in physically active elderly in the Netherlands. Eur J Nutr. 2019; 58: 3121-8.
- Sakem B, Nock C, Stanga Z, et al. Serum concentrations of 25-hydroxyvitamin D and immunoglobulins in an older Swiss cohort: results of the Senior Labor Study. BMC Med. 2013; 11: 176.
- Duarte C, Carvalheiro H, Rodrigues AM, et al. Prevalence of vitamin D deficiency and its predictors in the Portuguese population: a nationwide population-based study. Arch Osteoporos. 2020; 15: 36.
- Buchebner D, McGuigan F, Gerdhem P, et al. Vitamin D insufficiency over 5 years is associated with increased fracture risk-an observational cohort study of elderly women. Osteoporos Int. 2014; 25: 2767-75.
- Cashman KD, Kiely M, Kinsella M, et al. Evaluation of vitamin D standardization program protocols for standardizing serum 25-hydroxyvitamin D data: a case study of the program’s potential for national nutrition and health surveys. Am J Clin Nutr.
- Elmadfa I, Meyer AL, Wottawa D, et al. Vitamin D intake and status in Austria and its effects on some health indicators. Austin J Nutr Metab. 2017; 4: 1050.
- Pludowski P, Ducki C, Konstantynowicz J, et al. Vitamin D status in Poland. Pol Arch Med Wewn. 2016; 126: 530-9.
- Niculescu DA, Capatina CAM, Dusceac R, et al. Seasonal variation of serum vitamin D levels in Romania. Arch Osteoporos. 2017; 12: 113.
- Cashman KD, Dowling KG, Skrabakova Z, et al. Standardizing serum 25- hydroxyvitamin D data from four Nordic population samples using the vitamin D standardization program protocols: Shedding new light on vitamin D status in Nordic individuals. Scand J Clin Lab Invest. 2015; 75: 549-61.
- Cashman KD, Dowling KG, Skrabakova Z, et al. Vitamin D deficiency in Europe: pandemic? Am J Clin Nutr. 2016; 103: 1033-44.
- Kassi EN, Stavropoulos S, Kokkoris P, et al. Smoking is a significant determinant of low serum vitamin D in young and middle-aged healthy males. Hormones (Athens). 2015; 14: 245-50.
- Laktasic-Zerjavic N, Korsic M, Crncevic-Orlic Z, et al. Vitamin D status, dependence on age, and seasonal variations in the concentration of vitamin D in Croatian postmenopausal women initially screened for osteoporosis. Clin Rheumatol. 2010; 29: 861-7.
- Wei J, Zhu A, Ji JS. A comparison study of vitamin D deficiency among older adults in China and the United States. Sci Rep. 2019; 9: 19713.
- Robien K, Butler LM, Wang R, et al. Genetic and environmental predictors of serum 25-hydroxyvitamin D concentrations among middle-aged and elderly Chinese in Singapore. Br J Nutr. 2013; 109: 493-502.
- Nakamura K, Kitamura K, Takachi R, et al. Impact of demographic, environmental, and lifestyle factors on vitamin D sufficiency in 9084 Japanese adults. Bone. 2015; 74: 10-7.
- Shin JH, Lee HT, Lim YH, et al. Defining vitamin D deficiency and its relationship to hypertension in postmenopausal Korean women. J Women’s Health (Larchmt). 2015; 24: 1021-9.
- Gill TK, Hill CL, Shanahan EM, et al. Vitamin D levels in an Australian population. BMC Public Health. 2014; 14 :1001.
- Chin KY, Ima-Nirwana S, Ibrahim S, et al. Vitamin D status in Malaysian men and its associated factors. Nutrients. 2014; 6: 5419-33.
- Khosravi-Boroujeni H, Sarrafzadegan N, Sadeghi M, et al. Prevalence and trends of vitamin D deficiency among Iranian adults: A longitudinal study from 2001-2013. J Nutr Sci Vitaminol (Tokyo). 2017; 63: 284-90.
- Alfawaz H, Tamim H, Alharbi S, et al. Vitamin D status among patients visiting a tertiary care center in Riyadh, Saudi Arabia: a retrospective review of 3475 cases. BMC Public Health 2014; 14: 159.
- Mehboobali N, Iqbal SP, Iqbal MP. High prevalence of vitamin D deficiency and insufficiency in a low income peri-urban community in Karachi. J Pak Med Assoc. 2015; 65: 946-9.
- Saliba W, Rennert HS, Kershenbaum A, et al. Serum 25(OH)D concentrations in sunny Israel. Osteoporos Int. 2012; 23: 687-94.
- El-Menyar A, Rahil A, Dousa K, et al. Low vitamin d and cardiovascular risk factors in males and females from a sunny, rich country. Open Cardiovasc Med J. 2012; 6:
- Mechenro J, Venugopal G, Buvnesh Kumar et al. Vitamin D status in Kancheepuram District, Tamil Nadu, India. BMC Public Health. 2018; 18: 1345.
- Lips P, Cashman KD, Lamberg-Allardt C, et al. Current vitamin D status in European and Middle East countries and strategies to prevent vitamin D deficiency: a position statement of the European Calcified Tissue Society. Eur J Endocrinol. 2019; 180: P23-P54.
- Mendes MM, Hart KH, Botelho PB, Lanham SA. Vitamin D status in the tropics: is sunlight exposure the main determinant? Nutr Bull 2018;43:428-34
- Schleicher RL, Sternberg MR, Looker AC, et al. National estimates of serum total 25– hydroxyvitamin D and metabolite concentrations measured by liquid chromatography-tandem mass spectrometry in the US population during 2007-2010. J Nutr. 2016; 146: 1051-61.
- Grant WB, Lahore H, McDonnell SL, Baggerly CA, French CB, Aliano JL, Bhattoa HP. Evidence that vitamin D supplementation could reduce risk of influenza and COVID-19 infections and deaths. Nutrients. 2020;12.pii: E988. doi: 10.3390/nu12040988.
- Beard JA, Bearden A, Striker R. Vitamin D and the anti-viral state. J Clin Virol. 2011; 50: 194-200.
- Feldman D, Pike JW, Bouillon R, Giovannucci E, Goltzman D, Hewison M. (Eds.). (2017). Vitamin D: Volume 1: Biochemistry, Physiology and Diagnostics. Academic Press.
- Sajadi MM, Habibzadeh P, Vintzileos A, Shokouhi S, Shervin and Miralles-Wilhelm, F, Amoroso A. Temperature, humidity and latitude analysis to predict potential spread and seasonality for COVID-19 (March 5, 2020). Available at
- SSRN: https://ssrn.com/abstract=3550308 or http://dx.doi.org/10.2139/ssrn.3550308
- Welch D, Buonanno M, Grilj V, et al. Far-UVC light: A new tool to control the spread of airborne-mediated microbial diseases. Sci Rep. 2018; 8: 2752.
- Novel coronavirus pneumonia emergency response epidemiology team. The epidemiological characteristics of an outbreak of 2019 novel coronavirus diseases (COVID-19) in China. Zhonghua Liu Xing Bing Xue Za Zhi 2020; 41: 145-51.
- Alipio, Mark, Vitamin D supplementation could possibly improve clinical outcomes of patients infected with Coronavirus-2019 (COVID-2019) (April 9, 2020). Available at SSRN: https://ssrn.com/abstract=3571484 or http://dx.doi.org/10.2139/ssrn.3571484.
- Martineau AR, Jolliffe DA, Hooper RL, et al. Vitamin D supplementation to prevent acute respiratory tract infections: systematic review and meta-analysis of individual participant data. BMJ. 2017;356:i6583
- Mostafa WZ, Hegazy RA. Vitamin D and the skin: Focus on a complex relationship: A review. J Adv Res. 2015;6:793-804.
- As of Nov 25, 2021, the VitaminDWiki page had: 34 trials, 6 trial results, 28 meta-analyses and reviews, 64 observations, 36 recommendations, 55 associations, 89 speculations, 48 videos see related: Governments, HealthProblems, Hospitals, Dark Skins, 26 risk factors are ALL associated with low Vit D, Recent Virus pages Fight COVID-19 with 50K Vit D weekly Vaccines